Abstract
Objective: Multimorbidity in elderly patients increases complications and retards the recovery of pulmonary function after coronary artery bypass grafting (CABG) surgery. We aimed to evaluate the impact of multiple-intervention pulmonary rehabilitation (PR) on respiratory muscle strength and dyspnea scores after CABG in adult patients aged ≥65 years who had multimorbidity. Methods: A cohort study was retrospectively conducted with 95 adults aged ≥65 years who underwent CABG surgery and completed a multiple-intervention PR program. Results: Patients in the non-multimorbidity (n = 56) and multimorbidity groups (n = 39) were evaluated on the basis of their muscle strength, degree of dyspnea, and pulmonary function. Postoperative complications were compared after the completion of PR. Between extubation days 1 and 14, the multimorbidity group showed significant improvements in maximal inspiratory pressure (16.91 vs. 24.95 cmH2O, P < 0.001), Borg Scale score (0.99 vs. 2.3, P < 0.001), and the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC ratio) of 7.02% vs. 13.4% (P = 0.01). The incidence rates of pulmonary complications were similar between the two groups. Conclusions: Multi-interventional PR program significantly improved the maximal inspiratory pressure, Borg scale score, and FEV1/FVC ratio in the adult patients aged ≥65 years who had multimorbidity after undergoing CABG surgery.
Highlights
Multimorbidity refers to the coexistence of two or more chronic diseases in one patient, defined as the concurrent presence of two or more chronic disease in one patient, is the primary is the primary risk factor for adverse effects on health-related quality of life among patients who have undergone coronary artery bypass grafting (CABG) [1,2].Older adults aged ≥65 years who developed multimorbidity after undergoing CABG surgery tend to exhibit lower pulmonary function, and higher rates of complications and mortality than younger patients
We further evaluated the impact of age and gender to subgroups on maximal inspiratory pressure (MIP), Borg scale score, and
We further evaluated the impact of age and gender to subgroups on MIP, Borg scale score, and forced expiratory volume in 1 s (FEV1) /forced vital capacity (FVC) (Table 3)
Summary
Older adults aged ≥65 years who developed multimorbidity after undergoing CABG surgery tend to exhibit lower pulmonary function, and higher rates of complications and mortality than younger patients. McKellar reported a mortality rate of 7.3% at 30 days after CABG surgery in older adults [3]. Northrup reported that 60% of older adult patients had poor prognosis after heart surgery [4]. A large observational study of 35,173 Chinese patients who underwent CABG surgery reported a significant association between age and long-term mortality of >3 years [5]. A 10-year increment in patient age was associated with a higher mortality rate, with 1.77-, 1.97-, and 2-fold increases in 30-day, 180-day, and 3-year mortality rates, respectively [4]
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